Laparoscopy in infertility

Abstract

AIMS:
To have a comprehensive look at the pelvic organs to know their size, shape, structure, relationship with one another or any pathology of pelvic organs. To assess their role in causing infertility. To assess whether the pathology requires medical or surgical treatment i.e. to formulate the further line of management.
METHODS:All infertile patients (primary and secondary) anxious to conceive and willing to undergo diagnostic laparoscopy for evaluation of the same.
RESULTS: Our study was conducted in 100 cases of infertility patients out of which 72% were primary infertility and 28% were secondary infertility
Of the secondary infertility patients, 53.13% had a previous history of abortion, 37.5% had a previous normal delivery and 6.25% had previous intrauterine death.
Uterine factors were implicated in 23% of cases, out of which hypoplastic uterus and fibroid uterus contributed 4% and 8% respecively and mullerian anomalies were found in 11% cases. In our study there was no case of Endometrial tuberculosis.
Tubal factors were found in 27% of cases, out of which 1% had peritubal adhesions, and on chromopertubation test, bilateral tubal block was found in 3% and bilateral tubal patency in 79% cases.
Ovarian factors were implicated in 63% of cases out of which majority (57%) had PCOD. Among the peritoneal factors (20%), endometriosis was seen in 12% and pelvic adhesions were found in 6%. Inspite of thorough laparoscopic evaluation no cause (unexplained infertility) was found in 4% of cases and hence overall, the pelvic pathology was found in 96% of cases.
So the present study helps to establish beyond doubt that laparoscopy has an important role to play in evaluating infertility.